Active NPI
Nicole E Kautto, MA, BCBA
- Behavior Analyst
- Brooklyn Center, MN
National Provider Identifier
1124580337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 6701 Parkway Cir Ste 300
Brooklyn Center, MN 55430-2849 - Phone
- (763) 231-9094
- NPI assigned
- Apr 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
6701 Parkway Cir Ste 300
Brooklyn Center, MN 55430-2849
Mailing address
9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845
Phone (612) 728-5399
Other practice location 1
3333 University Ave SE
Minneapolis, MN 55414-3325
Phone (612) 728-5399 ext. 5427
Other practice location 2
9120 Springbrook Dr NW
Coon Rapids, MN 55433
Phone (763) 231-2590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fraser Child and Family Center | Past | Accepting new patients | |
| Fraser | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rehabilitation Clinic/Center
- Richfield, MN
- NPI 1063568574
-
- Adolescent and Children Mental Health Clinic/Center
- Minneapolis, MN
- NPI 1609922194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702598400000",
"number": "1124580337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9120 SPRINGBROOK DR NW",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "554335845",
"telephone_number": "612-728-5399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6701 PARKWAY CIR STE 300",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "554302849",
"telephone_number": "763-231-9094"
}
],
"practiceLocations": [
{
"address_1": "3333 University Ave SE",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554143325",
"country_code": "US",
"telephone_number": "612-728-5399 x5427",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9120 Springbrook Dr NW",
"address_purpose": "LOCATION",
"city": "Coon Rapids",
"state": "MN",
"postal_code": "55433",
"country_code": "US",
"telephone_number": "763-231-2590",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KAUTTO",
"first_name": "NICOLE",
"middle_name": "E",
"credential": "MA, BCBA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-05",
"last_updated": "2023-12-15",
"certification_date": "2023-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.